SONOGRAPHIC EVALUATION OF CAROTID-ARTERY ATHEROSCLEROSIS IN THE ELDERLY - RELATIONSHIP OF DISEASE SEVERITY TO STROKE AND TRANSIENT ISCHEMICATTACK

Doppler and real-time ultrasound (US) were performed to evaluate the e xtent of atherosclerotic changes in the carotid artery and to assess t heir relationship to prevalent cerebrovascular disease. Real-time US s cans and Doppler measurements of the carotid arteries were analyzed in 5,201 subjects aged 65 years or older. Severity of atherosclerotic le sions was associated with increased frequencies of hyperechoic, irregu lar, and heterogeneous textured lesions (P < .0001). The severity of i nternal carotid artery stenosis was associated with thickening of the intima-media layer of the common carotid artery wall (r = .37, P < .00 01). A history of stroke and transient ischemic attack (TIA) was more likely when hyperechoic, heterogeneous, and irregular lesions were see n in the carotid artery. Internal carotid artery stenosis correlated b etter with prevalent stroke and TIA than did sonographic descriptions of plaque texture. However, the prevalence of hyperechoic, heterogeneo us, and irregular lesions increased as the degree of internal carotid stenosis increased. On real-time images alone, the average of the inte rnal carotid artery maximal wall thickness is the sonographic measure of atherosclerosis that enables the best prediction of prevalent strok e and TIA.